OBJECTIVES: In the past decade, infection with the hepatitis C virus has turned out to be a major health threat among specific risk groups. Given the silent nature, but serious long term complications of hepatitis C infection, case finding is as difficult as it is vital. To improve hepatitis C case finding, the need for public campaigns is increasingly recognized. Three pilot campaigns have been performed in the Netherlands: a campaign aimed at the general population, the same campaign extended with a support programme for primary care and a campaign specifically aimed at hard drug users. The aim of this study is to evaluate cost-effectiveness (from a healthcare perspective) of these campaigns, when performed on a national scale. METHODS: Information gained during the pilot studies and estimations for costs for a national campaign were used to build a mathematical model to estimate the incremental cost-effectiveness ratios. The natural history of hepatitis C was described by a previously developed Markov model, that was adapted to the current Dutch situation. RESULTS: For the ‘support campaign’ the discounted incremental cost per tested person is €326 with an associated gain of 0.022 QALYs (~8 days). The resulting ICER is €14,980 per QALY. For the ‘drug users campaign’ the discounted incremental cost per tested person is €1960 with an associated gain of 0.168 QALYs. The resulting ICER is €11,747 per QALY. CONCLUSIONS: The campaign aimed at the general public without support for primary care did not improve case finding and was therefore not cost-effective. Considering a Dutch cut-off point of an ICER of €20,000 as a favourable cost-effectiveness ratio, both the campaign accompanied by additional support for primary care and the campaign aimed at hard drug users are to be considered a cost-effective investment to improve case finding and prevent future complications of hepatitis C.